Method and devices for flow occlusion during device exchanges

Abstract

Methods and devices for maintaining vascular access and/or minimizing bleeding during percutaneous interventions. The method can include advancing an access wire through a previously placed access catheter in a contralateral femoral artery to position an inflatable balloon on the access wire in a vascular access sheath located in an ipsilateral femoral artery, without using any additional guidewires to advance the access wire. After withdrawing the vascular access sheath at least partway out of the ipsilateral femoral artery to expose the vascular injury, the balloon can be inflated to occlude the ipsilateral femoral artery or an ipsilateral iliofemoral artery at or near the vascular injury.

The invention claimed is: 
     
       1. A method of treating a vascular injury occurring during or after an intravascular procedure, the method comprising:
 advancing an access wire having an inflatable balloon integral to the wire through a previously placed access catheter in a contralateral femoral artery to position the inflatable balloon integral to the access wire in a vascular access sheath located in an ipsilateral femoral artery, without using any additional guidewires to advance the access wire; 
 withdrawing the vascular access sheath at least partway out of the ipsilateral femoral artery to expose the vascular injury; 
 inflating the balloon to occlude the ipsilateral femoral artery or an ipsilateral iliofemoral artery at or near the vascular injury; 
 removing an inflation device from a proximal portion of the access wire, wherein a proximal end of the access wire is hubless, and wherein the balloon remains inflated after inflation device removal; 
 advancing at least one treatment device over the hubless proximal end of the access wire; and 
 treating the vascular injury using the at least one treatment device. 
 
     
     
       2. The method as in  claim 1 , wherein the access catheter is placed in the contralateral femoral artery before or during the intravascular procedure to provide contrast dye or other instruments during the procedure. 
     
     
       3. The method as in  claim 1 , wherein the access catheter comprises a curved distal portion for navigating around the aortic bifurcation, and wherein the method further comprises advancing the access catheter into the contralateral femoral artery. 
     
     
       4. The method as in  claim 1 , wherein advancing the access wire comprises advancing through the contralateral iliofemoral artery, through the aorta and into the ipsilateral iliofemoral artery. 
     
     
       5. The method as in  claim 4 , wherein the access wire has sufficient stiffness to support advancement of the at least one treatment device through at least one bend in a blood vessel. 
     
     
       6. The method as in  claim 1 , further comprising, before inflating the balloon: injecting contrast into the ipsilateral artery; and
 observing the contrast using a radiographic imaging device to evaluate whether the vascular injury exists. 
 
     
     
       7. The method as in  claim 1 , wherein inflating the balloon comprises inflating at a location of the vascular injury. 
     
     
       8. The method as in  claim 1 , wherein inflating the balloon comprises inflating at a location upstream of the vascular injury. 
     
     
       9. The method as in  claim 1 , wherein the treatment device comprises a stent deployment catheter, and wherein treating the vascular injury comprises placing a stent in the blood vessel. 
     
     
       10. The method as in  claim 1 , wherein the intravascular procedure comprises implantation of an aortic valve. 
     
     
       11. The method as in  claim 1 , wherein the intravascular procedure comprises an abdominal aortic aneurysm repair. 
     
     
       12. The method of treating a vascular injury occurring during or after an intravascular procedure, the method comprising:
 advancing an access wire having an inflatable balloon integral to the wire through a previously placed access catheter in a first iliofemoral artery to position the inflatable balloon integral to the access wire in a vascular access sheath located in a second iliofemoral artery, without using any additional guidewires or catheters other than the access catheter to advance the access wire; 
 locating the vascular injury in the second iliofemoral artery; 
 inflating the balloon to occlude the second iliofemoral artery at or near the vascular injury; 
 advancing at least one treatment device over a hubless proximal end of the access wire; and 
 treating the vascular injury using the at least one treatment device. 
 
     
     
       13. A method of treating a vascular injury occurring during or after an intravascular procedure, the method comprising:
 advancing an access wire having an inflatable balloon integral to the wire through a previously placed access catheter in a first femoral artery to position the inflatable balloon integral to the access wire in a vascular access sheath located in a second femoral artery, without using any additional guidewires to advance the access wire; 
 withdrawing the vascular access sheath at least partway out of the second femoral artery to expose the vascular injury; 
 inflating the balloon within the vascular access sheath to anchor the access wire relative to the sheath; 
 advancing at least one treatment device over a hubless proximal end of the access wire; and 
 treating the vascular injury using the at least one treatment device.